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Immunology > Boosting the immune response > Flashcards

Boosting the immune response Flashcards

1
Q

Triggered by IL12
Release IL2 and IFN-gamma
> Help CD8 cells to increase cell-mediated response against intracellular bacteria / protozoa
> Stimulate macrophages to form granulomas in IL12-IFNgamma network
Over-activation = Type 4 hypersensitivity

A

Th1 cells

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2
Q 
Release IL4
> Activate B cells (class switching)
> (Help with extracellular infections - Helminths)
Over-activation = Type 1 hypersensitivity (IgE production via B cells)
A

Th2 cells

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3
Q

3 mechanisms in B cell activation by Th2 cells

A
  1. CD40-CD40L
  2. TCR-MHC class II
  3. IL4
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4
Q

Different types of CD4 cells

A

Th1, Th2, Treg, Th17

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5
Q

> Maintain tolerance to self-antigen to prevent AI disease
(Respond to TGF-beta)
Release Foxp3

A

Treg

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6
Q

> Neutrophil recruitment
(Respond to IL6, TGF-beta)
(Release IL17, IL21, IL22)

A

Th17

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7
Q

Key IL released by CD4+ (Th2) for B cell activation

A

IL4

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8
Q

Key IL released by CD4+ (Th1) for CD8+ activation

A

IL2

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9
Q

What is the mechanism of immune memory?

A

APCs (incl. B cells) present antigen to CD4+ cells
Activation of B cells (via CD40 / IL4 / TCR) and CD8+ cells
Memory B cells / CD4+ / CD8+ cells form against antigen
These cells more accessible to produce faster + stronger immune response on secondary exposure to antigen

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10
Q

Central vs effector memory T cells

A

Central: T cells migrate efficently to LNs in response to antigen exposure - produce lots of IL2 but no IFN-gamma or perforin

Effector: T cells sit in organs waiting for exposure - produce lots of IFN-gamma and perforin but little IL2

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11
Q

Live (attenuated) vaccines

A

MMR (V) BOY

MMR, Varicella, BCG, Oral (Typhoid, Polio Sabin), Yellow fever

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12
Q

Types of inactivated vaccine

A

Inactive organisms
Component / sub-unit
Conjugate
Toxoid

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13
Q

What are the two types of Polio vaccine?

A 
Polio Sabin (oral)
Polio Salk (non-oral)
(Neither are given now, as polio has been successfully eradicated and giving would provoke more resistance than protection)
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14
Q

Polio Sabin

A

Oral

Live attenuated

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15
Q

Polio Salk

A

Non-oral

Inactivated

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16
Q

Mantoux test

A

Tuberculin bacteria purified protein derivative injected intradermally
Vaccinated / previously infected mount immune response

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17
Q

HA inhibition assay

A

Tests for influenza vaccination
Virus added to blood
Ab to HA prevents highly condensed sticking
Diffuse spot if Ab present / condensed spot if absent

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18
Q

What provides long-term immunity in:

a) TB vaccination
b) Influenza vaccination

A

a) T cells (‘T’B) (Type IV hypersensitivity)

b) Antibodies (Type II hypersensitivity)

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19
Q

Process of immune memory in vaccination

A

APCs present antigen to CD4+ cells - activate B

20
Q

Inactive organisms

A 
Hepatitis A
Cholera
Polio Salk
Influenza
Rabies
Pertussis
21
Q

Component

A

Influenza - HG, NA
HepB - HbS antigen
HPV - capsid

22
Q

Conjugate

A

(Encapsulated bacteria):
Hib
Pneumococcus

23
Q

Toxoid

A

Tetanus

Diphtheria

24
Q

Cholera
Rabies
Hepatitis A
Pertussis

A

Inactivated organism

‘CRAP’

25
Q

Influenza (HG, NA)
HepB (HbS)
HPV (capsid)

A

Component

26
Q

Pneumococcus

Hib

A

Conjugate

27
Q

Novel vaccine
Plasmid containing gene of choice inserted into muscle - protein presented on cell surface - mimics virally infected cell to stimulate CD8+
Danger of integration into host DNA
Currently on trial for West Nile Virus

A

DNA vaccine

28
Q

Acquired defect in DC function = malignancy

May be able to mount immune response against malignancy

A

Dendritic cell vaccine

29
Q

What are the 4 ways to boost the immune response?

A
  1. Vaccination
  2. Replace missing components
  3. Block immune checkpoints
  4. Cytokine therapy
30
Q

What is an adjuvant?

A

Increases immune response without altering specificity (creates ‘general inflammatory environment’)
Mimic PAMPs on TLR and other PRR

31
Q

Freund’s adjuvant

A

BCG

32
Q

Alum adjuvant

A

Provokes IL4 release to activate B cells

33
Q

ISCOM adjuvant

A

Immune stimulating complexes - saponins, cholesterol, protein

34
Q

CpG adjuvant

A

Cytosine and guanine separated by phosphate

Stimulate TLR9

35
Q

What are the main types of adjuvant?

A

Freund’s
Alum
CpG
ISCOM

36
Q

What missing components can be replaced?

A

HSC transplant
IVIG
T cells

37
Q

Permanent cure for life threatening ID (e.g. SCID, adhesion defect)

A

HSC transplant

38
Q

Non-specific or specific (e.g. IgG to VZV)
Specific used for post-exposure prophylaxis
Non-specific used for primary antibody deficiency (e.g. hyper IgM), or secondary (haem malignancies, post BM transplant)

A

Antibody replacement

39
Q

T cell replacement:

a) T cells removed, stimulated by tumour cell antigens + re-infused
b) T cells removed, specific TCR gene inserted into T cell DNA + re-infused
c) T cells removed, stimulated by specific antigen (EBV) + re-infused
d) T cells removed, specific gene to express receptors against targets on tumour cells)

A

a) Tumour infiltrating T cells
b) TCR T cells
c) Virus-specific T cells
d) CAR T cells

40
Q

Advanced melanoma treatments

A

Immune checkpoint blockers:

  • Anti-CTLA4
  • Anti-PD1
41
Q

Anti-CTLA4 as advanced melanoma treatment

A

Ipilimumab
Immune checkpoint blocker
(same CTLA4 system as abatacept - CTLA4 inhibits / CD28 stimulates T cells; CD80 and CD86 bind respectively - ipilimumab blocks CTLA4)

42
Q

Anti-PD1 as advanced melanoma treatment

A

Pembrolizumab, Nivolumab
Immune checkpoint blocker
PD-1 inhibits T cells

43
Q

-umab

A

Blocks immune checkpoint

CTLA4 or PD1

44
Q

CGD treatment

A

IFN-gamma

45
Q

Behcet’s, relapsing MS treatment

A

IFN-beta

46
Q

Hepatitis, Kaposi’s, hairy cell leukaemia, CML, MM treatment

A

IFN-alpha

Immunology (9 decks)

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